Placing breast implants to increase the size of the breasts seems deceptively simple. Candidates include women who feel that their breasts never developed to the desired proportion or who feel deflated following pregnancy or weight loss. But there are many subtleties to achieving a beautiful outcome. A quick online search shows a wide spectrum of results after breast augmentation, some superb but many more that lack a certain aesthetic. Of course, personal taste also varies. Breast implant surgery now is so common that the perception of what looks normal or natural has also changed. The key to success is matching the desired goals to what can be achieved surgically, and then planning and performing the procedure with precision and expertise.
There is no single measurement or tool to perfectly convey the desired postoperative goal. Measurement of cup size, trials of external sizers, computer simulations, before-and-after photographs and other factors are all considered. But nothing can take the place of a thorough consultation with Dr. Attkiss. During this visit, a detailed physical exam is performed with particular attention paid to the size and shape of the breasts, the width and form of the chest, the amount of fat tissue beneath the skin, the position of the nipple and areola, the degree of skin elasticity, existing asymmetry, among other things.
Choosing implant size is not the only important decision. A beautiful result also depends on selecting the appropriate implant shape and fill. In the United States, Mentor and Natrelle manufacture the vast majority of implants. Implants are filled with either saline or silicone gel with an outer shell that is either textured or smooth, and a shape that may be round or tear-dropped. The round implants are further divided into three different intensities, ranging from subtle to more projecting slopes when viewed from the side. And most recently, shaped, form stable (gummy bear) implants are now available in the United States. Though Dr. Attkiss most often uses smooth, round gel implants, each of these implants has a role, and may be used for the appropriate patient.
Scar placement must also be considered. Options include the crease beneath the breast, the edge of the areola or under the arm. This choice is dictated by one’s anatomy, the type of implant or one’s preference. Most of the time, the implant is placed in part beneath the chest muscle (subpectoral) or occasionally beneath the breast gland (subglandular).
Recovery after surgery is brief, but varies from person to person. Usually a narcotic is required for a day or two, and then Tylenol suffices. Aerobic and lifting activities are held for 2 to 3 weeks, and then gradually resumed. A support bra is provided and encouraged for a few weeks, but no special wrapping is required. Softening and settling of the implants occurs rapidly and complete adjustment takes a few months or more.
No procedure is without risk, and these risks are discussed verbally at the consultation and in written form at the preoperative visit. Even the latest generation of implants is not considered a lifetime device, so any woman who chooses implants is accepting additional surgery sometime in the future. In the case of breast augmentation, the overall benefit and degree of happiness usually far outweigh the risks, making it one of the most popular and satisfying cosmetic procedures.